AEGiS-08IAC: Clindamycin/primaquine versus trimethoprim/sulfamethoxazole as primary therapy for Pneumocystis carinii pneumonia in AIDS.

8th International AIDS Conference


Amsterdam, Netherlands — July 19-24, 1992

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Clindamycin/primaquine versus trimethoprim/sulfamethoxazole as primary therapy for Pneumocystis carinii pneumonia in AIDS.

Int Conf AIDS 1992 Jul 19-24; 8:We48 (abstract no. WeB 1020)
Toma E, Fournier S, Dumont M, Bolduc P, Deschamps H; Hotel-Dieu de Montreal, Canada.

OBJECTIVES: To assess the safety and efficacy of clindamycin/primaquine (C/P) in comparison with trimethoprim/sulfamethoxazole (TMP/SMX) as primary treatment of AIDS-related Pneumocystis carinii pneumonia (PCP).

METHODS: This was a randomized, double-blind trial conducted at one university hospital. Sixty-five individuals with a first episode of possible PCP were randomly assigned to receive C/P (34) or TMP/SMX plus folinic acid (31). Diphenhydramine was given to all patients from the 5th day of therapy. All but 5 subjects had a Pa O2 at entry higher than 50 torr. Intent-to-treat and analysis of only proven PCP were done. The main measurements were: the positive response, survival and relapse rates outcome of severity markers, incidence and severity of adverse reactions.

RESULTS: The 2 groups of patients had similar baseline characteristics. PCP was proven in 27 (C/P) and 22 (TMP/SMX) individuals respectively. The positive response (89 vs 91%) and survival rate within 2 months (93 vs 95%) were similar. The relapse rate was higher (30 vs 41%) but not significantly (p = 0.6) with TMP/SMX. The severity markers improved in parallel with the 2 therapies but dyspnea was ameliorated significantly (p 0.005) by day 3 only with C3P. The incidence and severity of adverse reactions were lower (p = 0.07 and 0.08 respectively) with C/P.

CONCLUSIONS: Although the slight differences between the 2 regimens were not significant (probably because of the small patient population) this trial favors C/P as primary therapy for AIDS-related PCP. Therefore, this study served to design a larger multicentre, clinical trial.

Keywords: AEGIS, Pneumonia, Pneumocystis carinii, Sulfamethoxazole, Trimethoprim, Acquired Immunodeficiency Syndrome, Primaquine, Clindamycin, Anti-Infective Agents, Survival Rate, Antifungal Agents, Double-Blind Method, Human, therapy, drug therapy, ICA8KWDaegis,pneumonia,pneumocystiscarinii,sulfamethoxazole,trimethoprim,acquiredimmunodeficiencysyndrome,primaquine,clindamycin,anti-infectiveagents,survivalrate,antifungalagents,double-blindmethod,human,therapy,drugtherapy,ica8
920719
WeB1020

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.